Lower Urinary Tract

Bladder cancer is one of the most common malignancies of the urinary tract. Carcinoma of the urinary bladder accounts for 7% of all malignant tumors in men and 4% in women (Parker 1997). More than 50,000 new cases of bladder cancer are diagnosed in the United States each year with the majority in men older than 60 years (Carson 1979; Lynch and COHEN 1995; Parker 1997). Ninety-five percent of these tumors are transitional cell carcinomas, with the rest being comprised of a mixture of squamous cell carcinoma, adenosquamous cell carcinoma and the rare sarcoma. Seventy percent of transitional cell carcinomas of the bladder are superficial, papillary tumors (Rife 1979; Messing 1995). Only 5% of patients with such tumors will die of their disease within 5 years following diagnosis, although 50% will develop another bladder tumor, usually of the same low-grade superficial type (Prout 1992). Many of these patients undergo surveillance cystoscopy at 3-6 month intervals. The remaining 30% of bladder tumors are invasive. These patients are treated using surgery, chemotherapy or a combination of the two.